The American Medical Association fully supports telehealth. The group now has gathered enough evidence of the effectiveness of telehealth and touts the advantages of telehealth to its member physicians. There are still a few ongoing issues involving compensation, privacy, liability, and of course, rural patients without broadband access.

The AMA has published a few case studies to help member physicians understand the range of benefits of telehealth. Following are a few of the many case studies highlighted by the AMA.

Telepsychiatry at Virginia Commonwealth University Health. The University serves a wide range of patients over a large footprint, including cities, suburbs and rural areas. VCU Health conducts from 3,000 – 5,000 psychiatric sessions per week and had launched an online trial of psychiatric visits before the pandemic and was conducting up to 20% of psychiatry sessions online when the pandemic hit in March 2020. The numbers flipped with the pandemic, and by April 2020, University Health conducted 90% of sessions online, with the rest in person in hospitals.

Over time it was discovered that patients liked having these visits from the comfort of their home and 80% of visits are still conducted online. The biggest overall benefit of the change to telehealth was that no-shows dropped from 11% pre-pandemic to 6% with more telehealth visits. This was partially credited to an online system that reminded patients of upcoming sessions.

Hypertension Program, Ochsner Health Systems. Ochsner is a non-profit academic health system that operates in over 90 clinics and 20 hospitals in and around New Orleans. Ochsner launched a virtual hypertension program in 2015, long before the pandemic. The program is aimed at helping patients control high blood pressure. A lot of the patients are elderly and low-income. Each patient is assigned a dedicated team consisting of a clinician, pharmacist, and health coach. Patents are given brood pressure monitors that report results back to Ochsner. The average patient checks blood pressure 42 times per week. Patients who aren’t submitting pressure readings get reminders.

The program has been extremely successful. 79% of the virtual patients maintain the desired blood pressure compared to only 26% using traditional office visits. Medication adherence improved by 14% for the on-line patients. The best result is that the out-of-pocket cost for online patients went down an average of $77 per month due to not needing live doctor visits.

Teleneurology and Telestroke – Massachusetts General Hospital. Mass General is a large teaching hospital located in Boston. The hospital tried the first trial with telestroke assistance in 2000 with a small remote hospital located in Martha’s Vineyard. The program provides specialists at Mass General to quickly help doctors at smaller hospitals understand if a patient is undergoing an acute ischemic stroke. If so, it’s vital to administer tPA, a lifesaving drug, within 60 minutes. The small hospital transmits brain scans and other data to Mass General to help in the diagnosis.

The trial was successful, and Mass General has extended the service to 34 community hospitals. This is a cost-savings program since otherwise, each small hospital is required to have a physician with acute stroke experience available 24/7. The Mass General team is able to respond to requests from smaller hospitals in an average of 5 minutes.